Determinants of COVID-19 Vaccine Acceptance Among the General Adult Population in Saudi Arabia Based on the Health Belief Model: A Web-Based Cross-Sectional Study

Background Many studies have been conducted worldwide and in the Kingdom of Saudi Arabia (KSA) during the current coronavirus disease 2019 (COVID-19) pandemic to assess the factors affecting COVID-19 vaccine acceptance. However, only some of these studies have adopted the Health Belief Model (HBM). This study aimed to assess the demographic characteristics and socio-psychological variables affecting the willingness to receive the COVID-19 vaccine among the general adult population in the KSA using the basic elements of the HBM. Methods A cross-sectional survey-based study was conducted. A Google Form questionnaire comprising 30 questions was distributed electronically using social media platforms. A univariate analysis using chi-square testing identified candidate variables for the multivariate logistic regression at a p-value of <.05 at 95% confidence interval (CI) set as a cut-off point. Multivariate logistic regression analysis was used to determine the association between multiple predictor variables and the dichotomized COVID-19 vaccine acceptance variable. Results A total of 1939 individuals participated in the current study. More than 73% were willing to take the vaccine, while the rest were either not willing (14.6%) or not sure (12.1%). The results showed that men were 1.29 times more likely to receive the COVID-19 vaccine than women (odds ratio, or OR = 1.29, 95% CI = 1.01-1.64, p = .04); those who were or had been a healthcare worker (HCW) were 1.43 times more likely to receive the COVID-19 vaccine compared with those who had never been a HCW (OR = 1.43, 95% CI = 1.10-1.87, p = .01). We found that perceiving the risk of contracting COVID-19 (OR = 2.86, 95% CI = 1.47-5.55, p = .00) and perceiving the severity of the disease (OR = 2.07, 95% CI = 1.08-3.96, p = .03) were positively associated with the willingness to receive the vaccine. Perceived barriers such as ineffectiveness of the vaccine (OR = 0.28, 95% CI = 0.18-0.44, p < .001), or believing the vaccine is just a media advertisement (OR = 0.56, 95% CI = 0.35-0.87, p = .01) were negative predictors of acceptance of the vaccine. Moreover, perceiving the benefits, such as life going back to normal (OR = 2.28, 95% CI = 1.37-3.77, p = .00) and recognizing the importance of the annual flu vaccine (OR = 3.43, 95% CI = 2.29-5.14, p < .001), were found to be positive predictors of acceptance of the vaccine. Finally, we also found that cues to action were positively associated with vaccine acceptance, that is, participants who were encouraged by their doctors (OR = 1.75, 95% CI = 1.17-2.60, p = .01), and family members or friends (OR = 2.89, 95% CI = 1.94-4.32, p < .001) were more willing to receive the COVID-19 vaccine than those who were not. Conclusions The current study provides valuable insights into the determinants of vaccine acceptance and hesitancy based on the HBM from a cognitive perspective. This could be useful in helping the government establish public health programs aimed at addressing barriers and false beliefs among the adult population, which could enhance the public’s willingness to receive COVID-19 vaccines and, ultimately, accelerate achieving herd immunity.